Organization
WELLBOUND OF MODESTO LLC
Active
Organization
WELLBOUND OF MODESTO LLC
Active
Parent organization
SATELLITE HEALTHCARE INC
Other names
Satellite WellBound of North Modesto
Organization subpart
Yes
Provider details
NPI number
Legal business name
SATELLITE HEALTHCARE INC
Authorized official
SUSAN L DEL BENE (SECRETARY/CFO)
(650) 404-3618
Entity
Organization
Contact information
Practice address
4207 BANGS AVE, STE 200, MODESTO, CA 95356-8714
(209) 338-2540
(209) 543-3897
Mailing address
300 SANTANA ROW, STE 300, SAN JOSE, CA 95128-2423
(209) 338-2540
(650) 625-6007
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841634144
—
CA
Enumeration date
04/18/2013
Last updated
12/29/2016
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